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Int J Surg Case Rep ; 19: 4-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26701843


INTRODUCTION: Anorectal abscess is one of the most common anorectal conditions encountered in practice. However, such abscesses may rarely extend upward and cause life-threatening medical conditions. PRESENTATION OF CASE: A 53-year-old woman presented with symptoms of anorectal abscess and evidence of severe inflammatory response and acute kidney injury. Computed tomography revealed a widespread abscess extending to the bilateral retroperitoneal spaces. Surgical drainage was performed via a totally extraperitoneal approach through a lower midline abdominal incision, and the patient had a rapid and uncomplicated recovery. DISCUSSION: Although retroperitoneal abscesses originating from the anorectal region are rare, they are life-threating events that require immediate treatment. Percutaneous abscess drainage has been recently evolved; however, surgical drainage is required sometimes that may be challenging, particularly in the case of widespread abscesses, as in our case. CONCLUSION: The midline extraperitoneal approach reported here might be an effective surgical option for patients with bilateral widespread retroperitoneal abscesses.

Nihon Shokakibyo Gakkai Zasshi ; 104(1): 47-51, 2007 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-17230006


In a 72 years old woman, abdominal computed tomography (CT) disclosed multicentric hypervascular tumor in S4 of the liver, and it was T1.T2 by the MRI, and a high signal was presented together. Stenosis was shown by ERCP at the same site. Cholangiocellular carcinoma was suspected before operation, but malignant change was not recognized by frozen section, so the operation was finished. Later, a diagnosis of solitary necrotic nodule of the liver was established by pathological diagnosis. Solitary necrotic nodule of the liver is a benign tumor.

Hepatopatias/diagnóstico , Neoplasias Hepáticas/diagnóstico , Fígado/patologia , Idoso , Carcinoma Hepatocelular/diagnóstico , Colangiopancreatografia Retrógrada Endoscópica , Diagnóstico Diferencial , Feminino , Humanos , Hepatopatias/patologia , Imageamento por Ressonância Magnética , Necrose , Tomografia Computadorizada por Raios X
Int J Clin Oncol ; 11(5): 416-9, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17058142


Pseudomyxoma peritonei is generally caused by appendiceal and ovarian tumors. Other primary sites have been rarely reported. We describe herein the second reported case of pseudomyxoma peritonei due to mucinous cystadenocarcinoma of the urachus. A 54-year-old man was admitted with a left inguinal hernia that had developed several months prior to his admission. During herniorrhaphy, we found a large amount of gelatinous mucinous material in the indirect-hernia sac and made a diagnosis of pseudomyxoma peritonei on cytological grounds. At re-operation, the origin of the pseudomyxoma peritonei proved to be a ruptured urachal cyst. The urachal cyst and the dome of the urinary bladder were excised. In addition, we removed as much of the gelatinous material as possible. On histological examination, a unilocular cyst was found to consist of noninvasive mucinous adenocarcinoma. We succeeded in removing the rest of the mucinous material by postoperative intraperitoneal lavage with dextran solution, and have observed no evidence of recurrence for 7 years since the operation.

Cistadenocarcinoma Mucinoso/diagnóstico , Hérnia Inguinal/etiologia , Neoplasias Primárias Múltiplas , Neoplasias Peritoneais/diagnóstico , Pseudomixoma Peritoneal/diagnóstico , Úraco , Cistadenocarcinoma Mucinoso/complicações , Cistadenocarcinoma Mucinoso/terapia , Hérnia Inguinal/diagnóstico , Hérnia Inguinal/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/terapia , Lavagem Peritoneal , Neoplasias Peritoneais/etiologia , Neoplasias Peritoneais/terapia , Pseudomixoma Peritoneal/etiologia , Pseudomixoma Peritoneal/terapia , Resultado do Tratamento , Cisto do Úraco/complicações
Gastric Cancer ; 6(3): 168-72, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14520530


BACKGROUND: Assessment of malignant potential in gastrointestinal stromal tumors (GISTs) is still problematic. The maximum tumor diameter and the mitotic index are generally used as an index of malignancy of GISTs. The Ki-67 labeling index has recently been used as an index of cell growth, and the prognosis of GISTs was reported to be significantly poor when the value of this index was 10% or higher. METHODS: Clinicopathological and immunohistological factors were analyzed in 15 patients who underwent surgical resection of gastric stromal tumors at our department between April 1997 and July 2002. The patients were divided into "metastasis/recurrence" and "benign" groups. Also, the relationship of changes in the Ki-67 labeling index to the degree of malignancy in recurrent lesions was assessed in an 84-year-old woman who underwent five reoperations because of recurrences in the peritoneum. RESULTS: Significant differences were noted between the metastasis/recurrence and benign groups in relation to the mean maximum tumor diameter (186.7 +/- 80.8 mm vs 41.3 +/- 22.9 mm), mitotic index (88.3 +/- 5.0/50 high-power fields [HPF] vs 3.0 +/- 2.9/50 HPF), and the Ki-67 labeling index (11.4 +/- 2.5% vs 0.01 +/- 0.51%). In the patient who had metastasis to the liver 3.5 years after initial operation and underwent five reoperations before death, the intervals until detection of recurrence tended to be shortened gradually. The Ki-67 labeling index varied with each operation, and tended to be higher at the time of reoperations than at the initial operation. CONCLUSION: The maximum tumor diameter, mitotic index, and Ki-67 labeling index were useful as an index of malignancy for gastric stromal tumor. The efficacy of surgical resection alone may be insufficient in patients with disseminated metastasis to the peritoneum.

Antígeno Ki-67/análise , Mesenquimoma/patologia , Neoplasias Gástricas/patologia , Idoso , Idoso de 80 Anos ou mais , Antígenos de Neoplasias/análise , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Hepáticas/secundário , Masculino , Mesenquimoma/secundário , Mesenquimoma/cirurgia , Pessoa de Meia-Idade , Índice Mitótico , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Peritoneais/secundário , Reoperação , Neoplasias Gástricas/cirurgia , Células Estromais/patologia
Gan To Kagaku Ryoho ; 29(5): 757-60, 2002 May.
Artigo em Japonês | MEDLINE | ID: mdl-12040680


A 64-year-old-male had recurrent paraaortic lymph node and liver metastases eight months after total gastrectomy and with distal pancreatectomy and splenectomy for advanced gastric cancer. Combined chemotherapy with 5-FU and a low-dose of CDDP was effective and the both lesions disappeared. Thirteen months later, a second recurrence of anterior mediastinum lymph node metastases occurred. After the same protocol, the lesions showed a partial response and lymph node dissection was performed. Histopathological examination showed that the resected lymph nodes had 99% necrosis and fibrotic change. Immunohistochemical examination of p53 of the primary gastric cancer showed negative staining. The patient has been followed for three years after the operation, and has no recurrent lesions.

Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Gastrectomia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Linfonodos/patologia , Neoplasias Gástricas/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Aorta/patologia , Cisplatino/administração & dosagem , Esquema de Medicação , Fluoruracila/administração & dosagem , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Mediastino/patologia , Pessoa de Meia-Idade , Pancreatectomia , Esplenectomia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia